Skip Navigation LinksHome > March 2012 - Volume 23 - Issue 2 > Estimation With Cox Models: Cause-specific Survival Analysi...
Epidemiology:
doi: 10.1097/EDE.0b013e3182454cad
Survival

Estimation With Cox Models: Cause-specific Survival Analysis With Misclassified Cause of Failure

Van Rompaye, Barta; Jaffar, Shabbarb; Goetghebeur, Elsa

Supplemental Author Material
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Abstract

While epidemiologic and clinical research often aims to analyze predictors of specific endpoints, time-to-the-specific-event analysis can be hampered by problems with cause ascertainment. Under typical assumptions of competing risks analysis (and missing-data settings), we correct the cause-specific proportional hazards analysis when information on the reliability of diagnosis is available. Our method avoids bias in effect estimates at low cost in variance, thus offering a perspective for better-informed decision making. The ratio of different cause-specific hazards can be estimated flexibly for this purpose. It thus complements an all-cause analysis. In a sensitivity analysis, this approach can reveal the likely extent and direction of the bias of a standard cause-specific analysis when the diagnosis is suspect. These 2 uses are illustrated in a randomized vaccine trial and an epidemiologic cohort study, respectively.

© 2012 Lippincott Williams & Wilkins, Inc.

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